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Personality and recovery: integrating personality assessment data to facilitate the recovery process.

The relatively enduring and persistent nature of personality traits means that they will likely continue to impact the course of psychiatric recovery after Axis I symptoms are stabilized. These traits can significantly impact the choices that recovering persons make and the quality of interpersonal relationships with care providers who are trying to facilitate the recovery process. Despite this, they are often inadequately assessed and considered in providing psychiatric care. This manuscript reviews the common combinations of personality traits that have emerged across a variety of clinical samples. The implications of these personality features for the provision of care in an inpatient setting to facilitate recovery are discussed.

Convalescence↗

Minnesota Multiphasic Personality Inventory profile characteristics of schizotypal personality disorder.

The goal of the present study was to determine whether precursors for psychopathology can be found in personality dimensions of the general population. Two hundred and 62 university students were compared with 41 schizophrenic patients and 18 patients with schizotypal personality disorder (SPD) on the Minnesota Multiphasic Personality Inventory (MMPI). Schizotypal personality disorder patients showed significantly elevated Pt and Si scales compared with the schizophrenic patients. Schizophrenia and SPD groups generally produced two-point codetypes of 6-8/8-6, 2-6/6-2, 7-8/8-7, and 7-8/8-7, 2-7/7-2, 6-8/8-6. A total of 77.5% of students had no codetype with a T-value of > or = 70, although the frequency of codetypes of spike 5, spike 0 and 2-7/7-2 was relatively high in the student group compared with the general population. Discriminant function analysis of the MMPI profiles revealed significant variance among the three groups. The overall rate of correct classification of the subjects into schizophrenia, SPD or university students was 90.3%. The first coefficient, mainly defined by a negative weight on the Sc scale, best distinguished the patients with either schizophrenia or SPD from the students. The second coefficient, defined by negative weights on the Sc and Si scales, and positive weights on the F and Ma scales identified patients with schizophrenia and SPD patients. The Harris-Lingoes subscales, which are supposed to provide the profile patterns characteristic of schizotypy, well discriminated the three groups. These results suggest the usefulness of the MMPI subscales for the detection of subjects with the SPD trait.

Adolescent↗

Personality factors, family structure, and sex of drawn figure on the Draw-A-Person Test.

One hundred seventy-four youthful psychiatric inpatients were given the Draw-A-Person Test (DAP) as part of an assessment battery. Sex of person drawn was compared to subject's sex, Achenbach aggression and delinquency scores, and scores on Children's Inventory of Anger and Nowicki-Strickland Locus of Control Scale. The sex of the person drawn was also compared to family composition, specifically whether or not the child came from an intact family with both a male and female parent or role model. Results support drawing of a same-sexed individual as normative, regardless of age or sex. Adolescent girls and young boys were the only groups that differed significantly from this norm. Personality measures and family composition were not significantly related to the tendency to draw same versus opposite sex.

Adjustment Disorders↗

Premorbid personality predicts level of rated personality change in patients with Alzheimer disease.

Multiple studies of individuals with Alzheimer disease have substantiated significant levels of informant-rated change in several domains and facets of the Neuroticism-Extraversion-Openness Personality Inventory, including increases in Neuroticism and decreases in Extraversion and Conscientiousness relative to premorbid personality traits. Decline in Openness was cited in some reports, and replicable changes were identified in several facets. Current and premorbid personality of 50 patients with Alzheimer disease were rated by informants using the Neuroticism-Extraversion-Openness Personality Inventory. Multiple regression analysis was used to assess possible relationships of levels of reported change with covariates, including premorbid rating, education, duration of dementia, age, gender, and Mini-Mental State Examination score. Premorbid rating was the only significant predictor of reported change for Neuroticism, Extraversion, Conscientiousness, and the facets Anxiety (N1), Assertiveness (E3), and Activity (E4). Rated change in Depression was also found to be related to duration of dementia, change in Vulnerability was influenced by gender, and reported change in both Openness and Ideas showed a relationship to level of education.

Aged↗

Personality disorders and the trimensional personality questionnaire factors in major depressive disorder.

We assessed the potential relationship between personality disorder (PD) clusters, as assessed by the SCID-II, and temperamental traits assessed by the Tridimensional Personality Questionnaire (TPQ) among a well-characterized, unmedicated cohort of outpatients with major depressive disorder (MDD). The TPQ and SCID-II were administered to 263 depressed outpatients (mean age = 39.9 +/- 10.5 years; women = 139, 53%; initial 17-item Hamilton Rating Scale for Depression = 19.6 +/- 3.4) who currently met criteria for MDD and who were enrolled in an 8-week treatment trial. The multiple linear regression method was used to evaluate the relationship between TPQ factors and personality disorder clusters, controlling for age, gender, and initial 17-item Hamilton Rating Scale for Depression score as necessary. Among outpatients with MDD, meeting criteria for a Cluster A PD diagnosis was related to high harm avoidance (HA) scores, as well as low reward dependence and novelty seeking (NS) scores. Additionally, high HA scores were associated with meeting criteria for a Cluster C PD diagnosis, while high NS scores were associated with meeting criteria for a Cluster B PD diagnosis. Certain temperament traits, especially HA and NS, appear to be associated with specific patterns of personality clusters among depressed patients.

Adult↗

Personality and mood correlates of avoidant personality disorder.

Avoidant personality disorder (APD) has been recognized as prevalent and clinically important; however, it is not clear how APD maps onto established personality and mood dimensions. In this cross-sectional survey study, 365 college students completed questionnaires assessing APD features and theoretically relevant personality and mood dimensions. Based on these self-report data, 6.6% may meet DSM-IV criteria for APD. Hierarchical regression analyses showed that APD features were associated with introversion, neuroticism, low self-esteem, and pessimistic expectancies. Additionally, APD features were linked with self-reports of elevated emotional responsiveness to threats and reduced emotional responsiveness to incentives (the behavioral inhibition system and behavioral activation system scales). After controlling for the effects of other personality, temperament, and cognitive measures, affective distress (i.e., anger, anxiety, and depression) was no longer related to APD. Results are consistent with APD models that emphasize the joint influences of emotional vulnerability and social-cognitive triggering and sustaining factors.

Adolescent↗

Personality disorders and personality dimensions in anorexia nervosa.

Information on the relationship between anorexia nervosa (AN) and personality disorders (PDs) and dimensions of temperament and character (measured by the Temperament and Character Inventory [TCI; Cloninger, Przybeck Svrakic, & Wetzel, 1994]) is limited. This study examines the predictive validity of the TCI for PD diagnoses assessed by the International Personality Disorder Examination-ICD-10 (IPDE-ICD-10; Loranger, Janca, & Sartorius, 1997) interviews of 46 women with DSM-IV-defined AN. Patients with a PD reported higher levels of harm-avoidance and lower levels of self-directedness than those without a PD. Scores on the TCI were predictive of the number of PD features present, particularly for those PDs in the anankastic, anxious, and dependent groups accounting for 40% to 51% of the variance. Cluster analysis based on scores on the TCI identified a subgroup of patients characterized by low levels of novelty seeking, self-directedness, and cooperativeness and high levels of harm avoidance. This cluster included the majority of those with avoidant, anxious, or dependent PDs. Assessment of particular personality dimensions was able to predict PDs in an anorexic sample. Since normal personality dimensions have greater validity than the categorical PDs, a consideration of normal temperament and character may assist in clinical decisionmaking and considerations concerning treatment.

Adult↗

Individual differences in cognitive strategy and personality traits as measured by the Sixteen Personality Factor Questionnaire.

The relationship between personality and preference for use of the right or left hemisphere of the brain in cognitive processing was investigated. Lateral eye movements were recorded as 50 female and 20 male right-handed subjects considered questions requiring reflection. The questions were not obviously "verbal" or "spatial" in nature but did require differing levels of reflection. Questions requiring higher levels of reflection produced a higher rate of lateral eye movement responses. Percent right eye movement for individual subjects was then correlated with scores on the Sixteen Personality Factor Questionnaire, using both first-order factors and the second-order factor Cortertia, which has some face validity as describing the personality generally ascribed to those who produce mostly right lateral eye movements. No correlation was found between the preferred directions of eye movements and 16 PF factors, which suggests that the lateral eye movements reflect thinking and problem-solving strategies but are not associated with personality styles.

Adolescent↗

Treating personality fragmentation and dissociation in borderline personality disorder: a pilot study of the impact of cognitive analytic therapy.

Recent findings suggest that personality fragmentation may be a core component of borderline personality disorder (BPD) and that successful treatment of BPD may depend on the extent to which this is addressed. Cognitive analytic therapy (CAT) can increase integration by strengthening awareness, and hence control, of the dissociative processes maintaining fragmentation. This pilot study aimed to conduct a systematic evaluation of the impact of CAT on BPD severity and personality integration. A patient series within-subject design was used. Five BPD participants completed a series of assessments to evaluate the impact of therapy on BPD severity, fragmentation, dissociation, symptomatology and interpersonal adjustment before, during and following 16-session CAT. By follow-up, CAT had produced reductions in the severity of BPD for all five participants, and three participants showed significant changes in their levels of personality fragmentation. Improvements in comorbid disturbance were less consistent, however. Although the small number of participants involved limits these findings, they have theoretical and clinical interest. They generally support the suggestion that integration should be enhanced with BPD patients, and suggest that CAT may be a useful method to achieve this goal.

Adult↗

[Connection between personality and emotional intelligence in groups of patients after suicidal attempts and ethanol dependent persons].

The aim of the study was to examine relationship between personality and emotional intelligence in two groups. The first group included patients hospitalized for suicide attempts in the Department of Clinical Toxicology CMUJ, the second one included ethanol dependent patients hospitalized in detoxification unit. The study included 103 persons: 52 in the study group of patients after suicidal attempt and 51 in the ethanol dependent patients group. Personality was described according to the one of most popular concepts--Costa and McCrae's Big Five Model, including five major factors: neuroticism, extraversion, openness to experience, agreeableness and conscientiousness. The second problem discussed in this study was emotional intelligence understood as ability to follow one's own and others' emotions, differentiate them and use this information in directing one's own thinking and action. In this study Costa and McCrae's Five-Factor Inventory (NEO) and N. S. Schutte's Emotional Intelligence Questionnaire were used. The analysis of their results in our two groups confirmed the hypothesis of relationship between emotional intelligence and personality.

Adult↗

Era-related changes in the Japanese cultural and social structure and conformist personality pathology--with a particular emphasis on borderline personality disorder.

We discussed relationship between the change of social structure and the specific conformist personality pathology, that is, Morita shinkeishitsu and borderline personality disorder. Morita shinkeishitsu that has been regarded as a basic pathology of broad range of neurosis is seldom seen in daily practice these days. On the other hand, borderline personality disorder that is a relatively new diagnostic domain is regarded as having a contemporary pathology, for example impulsivity, drug and sex abuse, and fragile interpersonal relationship. We consider that Morita shinkeshitsu corresponds to an industrialized society and that borderline personality disorder corresponds to a post industrialized (information based) society. This assumption should be leaded to the further discussion from a point of view of treatment.

Borderline Personality Disorder↗

Calibrating the physician. Personal awareness and effective patient care. Working Group on Promoting Physician Personal Awareness, American Academy on Physician and Patient.

Physicians' personal characteristics, their past experiences, values, attitudes, and biases can have important effects on communication with patients; being aware of these characteristics can enhance communication. Because medical training and continuing education programs rarely undertake an organized approach to promoting personal awareness, we propose a "curriculum" of 4 core topics for reflection and discussion. The topics are physicians' beliefs and attitudes, physicians' feelings and emotional responses in patient care, challenging clinical situations, and physician self-care. We present examples of organized activities that can promote physician personal awareness such as support groups, Balint groups, and discussions of meaningful experiences in medicine. Experience with these activities suggests that through enhancing personal awareness physicians can improve their clinical care and increase satisfaction with work, relationships, and themselves.

Attitude of Health Personnel↗

Describing depressive personality analogues and dysthymics on the NEO-Personality Inventory-Revised.

The purpose of this study was twofold: (a) To test Widiger, Trull, Clarkin, Sanderson, and Costa's (1994) description of depressive personalities' profile scores on the NEO-Personality Inventory-Revised (NEO-PI-R; Costa & McCrae, 1992); and (b) to determine the degree of empirical overlap between depressive personality analogues and dysthymics on the NEO-PI-R. As predicted, depressive personality analogues (DPAs) had significantly higher mean scores on the Anxiety, Depression, and Self-Consciousness NEO-PI-R facets of Neuroticism than did controls, but not on the Tendermindedness facet. On the second question of interest, DPAs and dysthymics significantly differed on the Self-Consciousness and Gregariousness facets and clinically differed on the Neuroticism, Openness, and Agreeableness factors, and on the Angry Hostility, Depression, and Positive Emotions facets. Despite overlap on other factors and facets, it is concluded that DPAs can be meaningfully differentiated from dysthymia on the NEO-PI-R.

Adolescent↗

[Aerobic capacity estimated from heart rate under submaximal load: an indicator of complaints, personality, personal activity and social status].

In 34 young females (mean: 21 years, range 18-30), working with VDTs, maximum aerobic capacity (MAC) was estimated by use of a cycle ergometer and Astrand's nomogram. MAC correlated with musculoskeletal complaints (-.29, p less than .05), eye complaints (-.36, p less than .05), personal activity (.38, p less than .05), personality dimensions: "Imperturbability" (.41, p less than .01), "Wellbeing" (.31, p less than .05), "Traditionalism" (-.45, p less than .01) and "Psychophysic constitution" (all evaluated by questionnaires), a body weight index (-.51, p less than .01) and systolic blood pressure after performance (-.51, p less than .01). MAC also distinguished significantly between a priori classified subgroups with seldom or frequent musculoskeletal complaints, the latter scoring higher (31 vs. 25 ml O2/kg X min), and subgroups with high or low EMG values of the trapezius muscle, measured at the workplace (25 vs. 33 ml O2/kg X min). A similarly ascertained MAC separated a comparable group of 55 young female university students (mean: 21 years, range 19 to 27) from the VDT users (38 vs. 27 ml O2/kg X min). It is concluded that the indirect estimation of MAC using Astrands nomogram is sensitive enough for certain practical uses and that MAC shows significantly plausible relations to a set of personality factors, social status, complaints and physiological variables to serve as a reliable indicator for personal fitness.

Adolescent↗

Personality and personality disorders in chronic pain.

Personality characteristics and disorders have long been noted in the chronic pain population. Clinicians and researchers alike will attest to the high rates of personality difficulties encountered in these individuals. Historically, it has been found that certain personality styles such as hypochondriasis and hysteria are common in chronic pain suffers. In addition, the prevalence of personality disorders (PDs) is significantly greater in the pain population than in the general population or in medical or psychiatric populations. A diathesis-stress model has been suggested to account for this finding and is discussed in this article, with implications for both treatment and research.

Chronic Disease↗

Unilateral neglect: personal and extra-personal.

Ninety-seven right brain-damaged patients were given two tasks aimed at assessing unilateral neglect in personal and in extra-personal space. The frequency of the two aspects of neglect, as well as their patterns of association with each other and with more elementary neurological disorders are reported and discussed. The results suggest a non-unitary frame of spatial reference for unilateral neglect, which may tentatively be interpreted in terms of a personal vs extra-personal dichotomy.

Animals↗

Clinical, cognitive, and social characteristics of a sample of neuroleptic-naive persons with schizotypal personality disorder.

INTRODUCTION: Schizotypal personality disorder (SPD) shares with schizophrenia many biological features, yet little is known about the clinical characteristics of persons diagnosed with this disorder. This report describes the clinical, cognitive and socio-occupational characteristics of a community sample of subjects diagnosed with SPD. METHOD: Sixty-four male and 40 female neuroleptic-naive DSM-IV SPD subjects and 59 male and 51 female comparison subjects were recruited from the community for a total sample of 214 subjects. Demographic and cognitive differences between groups and, within the SPD group, the effect of gender on clinical features, such as the SPD criteria, SAPS, SANS, Schizotypal Personality Questionnaire, and co-morbidity, were examined using ANOVA and Chi-square distributions. RESULTS: SPD subjects, in contrast to comparison subjects, had significantly lower socio-economic status, poorer social relationships and skills, and lower vocabulary scores. Furthermore, SPD subjects demonstrated more impairment on Vocabulary scores than on Block Design, as measured by the WAIS-R, a pattern not seen in comparison subjects. In the SPD cohort, positive symptoms predominated and nearly half were co-morbid for major depression. With respect to gender, male SPD subjects, compared with female SPD subjects, evinced significantly more negative symptoms, fewer friends, had more odd speech, and were more likely to also suffer from paranoid and narcissistic personality disorders. In contrast to male SPD subjects, female SPD subjects perceived themselves to be more disorganized. CONCLUSIONS: SPD subjects, similar to schizophrenics, are impaired socially, occupationally, and cognitively, particularly in the area of verbal measures. Moreover, male SPD subjects may be more severely affected than female SPD subjects across multiple domains of functioning.

Adolescent↗